J Korean Ophthalmol Soc.  1996 Nov;37(11):1958-1962.

A Case of Wernicke's Encephalopathy after Long-Term Intravenous Feeding

• Kim JH
• Kim DS
• Shin JC

Abstract

Wernicke's encephalopathy is characterized by one or more following symptoms: nystagmus, ophthalmoplegia, such as lateral rectus muscle palsy and conjugate palsy, ataxia of gate and mental confusion. The main cause of Wernicke's encephalopathy is malnutrition associated with chronic alcholism, but it occurs in such conditions as pyloric stenosis, hyperemesis gravidarum, gastrointestinal malignancy, chronic starvation therapy for obesity, and so on. We experienced a 38-year-old patient with Wernicke's encephalopathy, who had about 1 month intravenous feeding, preceded by intractable vomiting. The patient showed complete bilateral horizontal conjugate gaze palsy and abduction palsy, but spa ired vertical gaze and convergence without nystagmus. Ophthalmoplegia was improved after parenteral thiamine administration, but horizontal gaze evoked nystagmus occurred and persisted after 6months. We report a case of Wernicke's encephalopathy which occurred after long term intravenous feeding unassociated with chronic alcoholism.

Keyword

Ophthalmoplegia; Thiamine; Wernicke's encephalopathy

MeSH Terms

Adult
Alcoholism
Ataxia
Female
Humans
Hyperemesis Gravidarum
Malnutrition
Obesity
Ophthalmoplegia
Paralysis
Parenteral Nutrition*
Pregnancy
Pyloric Stenosis
Starvation
Thiamine
Vomiting
Wernicke Encephalopathy*
Thiamine